Dietary Advice


Abi Purrington

Specialist Dietary Blogger

Hi, I'm Abi and I'm a gluten and dairy free food blogger and recipe writer.

You have probably come to this section of the website newly diagnosed with BAD and wondering what on earth you can now safely eat and how you can reduce your symptoms by controlling your diet. That's exactly the position I found myself in this year in June 2016. I have suffered with IBS symptoms for 20 years, I have been cooking and eating gluten & dairy free food for 4 years and then recently I have been diagnosed with BAD.

It's my personal experience that brings me here.

I am a home cook who has learnt through years of trial and error how to control my symptoms through controlling my diet and I hope that I am in a good position to be able to offer you some dietary advice based on my experience of eating and cooking free-from food and my recent experience of eating and cooking BAD friendly foods.

I would like to point out though that I am not a dietician or a member of the medical community and I have done no nutritional training. I am going to be writing some specifically gut-friendly recipes for you all to try out at home and I hope they will be able to at least offer you some foodie inspiration for the days when you're suffering and frustrated with figuring out what you can and can't eat.

I will try to cover all the typical food triggers including fats, gluten, dairy and some fodmap foods but I can't promise that every recipe will suit every person. Some you will need to adapt but I will try and give advice on substitutions or alternative things you can try.

I hope it will help you if you've been newly diagnosed or if you're fed up with limiting your food choices or if you're bored with what you cook at home. I hope my experience can help you to gain control over your diet and that it will help alleviate at least some of your BAD symptoms.

I know from personal experience that gaining control of your diet and making changes that will improve the symptoms that you are suffering with is one of the most pro-active and rewarding things that you can do. However I also know that it is one of the hardest things that you can do.

The reason is that there is not a one-fits-all diet plan that will work for everyone.

I am sure that an awful lot of BAD sufferers will have tried a variety of exclusion diets in an attempt to figure out what is causing their symptoms with a variety of outcomes. Personally I have tried being gluten free, dairy free and the FoDMAP diet and discovered that some triggers are consistent and that others are not.

The important thing to remember when trying to gain control over your BAD symptoms is the biological mechanism that causes Bile Acid Diarrhoea in the first place. When the body is trying to digest food (particularly fats) it produces bile acid in order to aid that digestion. But in people with BAD too much bile acid is produced, causing excess water to be created in the intestines, which results in a fast transit of stool through the digestive system, equalling diarrhoea. The important thing was…..particularly fats.

So what is the one dietary change that everyone with BAM can make?

Reduce your fat intake.

Clinical information on the effect of a low fat diet on BAD is limited.  However, it is generally recommended that a low fat diet (less than 40g a day and not all at once) should be followed.  

Is it as easy as that though? Unfortunately not.

For some patients, once they are tolerating the bile binder medication, they find that they can eat a reasonably unrestricted diet and are able to include a normal amount of fat in their diet. But for other patients it is more of a sliding scale of tolerance. For some a low fat diet is critical, for others a moderately low fat diet is all they need. Everyone has a different response. The digestive system is a notoriously sensitive body organ and everyone has different reactions, tolerances, sensitivities and triggers to food.

Ensuring that you do not miss taking your bind binders is really important as symptoms return very quickly. For some of us the impact is fairly quick within hours / same day. For others the impact can be the subsequent day. Most of us find that if doses are missed it takes a few days / weeks for the symptoms to resolve. Keeping a supply of the bile binders in your handbag and wallet is a good idea so if you forget to take them before you leave the house you have some with you. Some of us keep a larger supply in our cars (which we rotate to ensure they do not go past the expiry date) so if we go away with work or for the weekend and forget to take our medication we have an emergency supply. Ask your GP to prescribe a couple of weeks extra supply so you can have an emergency back up in places that work for you.

We have also found that we need to drink plenty of fluids and that the bile binders are more effective when we are well hydrated.